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EF5 in Assessing Tumor Response to Anticancer Therapy in Patients With Stage I, Stage II, or Stage III Non-Small Cell Lung Cancer

This study has been completed.
National Cancer Institute (NCI)
Information provided by:
National Cancer Institute (NCI) Identifier:
First received: July 8, 2002
Last updated: April 30, 2015
Last verified: September 2006

RATIONALE: Knowing the level of oxygen in tumor tissue may help predict the effectiveness of anticancer therapy. EF5 is a drug used in the measurement of oxygen in tumor tissue.

PURPOSE: Phase II trial to study the effectiveness of EF5 in assessing tumor response to anticancer therapy in patients who have stage I, stage II, or stage III non-small cell lung cancer.

Condition Intervention Phase
Lung Cancer Drug: EF5 Other: flow cytometry Other: immunohistochemistry staining method Phase 2

Study Type: Interventional
Study Design: Primary Purpose: Diagnostic
Official Title: Pilot Phase II Research Study of EF5 to Measure Tumor Hypoxia in Patients With Non-Small Cell Lung Cancer

Resource links provided by NLM:

Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Frequency and degree of hypoxia as measured by EF5 binding at 24 to 48 hrs. after study drug infusion

Secondary Outcome Measures:
  • Correlation of hypoxia with serum/plasma markers of hypoxia, tissue markers of hypoxia, tumor angiogenesis, apoptosis, tumor perfusion, and microvessel density at 24 to 48 hrs. after study drug infusion
  • Longevity of EF5 adducts as measured by EF5 binding

Estimated Enrollment: 60
Study Start Date: May 2002
Study Completion Date: April 2014
Primary Completion Date: September 2007 (Final data collection date for primary outcome measure)
Detailed Description:


  • Assess the frequency and degree of hypoxia as measured by etanidazole derivative EF5 binding in patients with stage I, II, or III non-small cell lung cancer.
  • Correlate hypoxia as measured by EF5 binding with potential serum/plasma markers and tissue markers of hypoxia in these patients.
  • Correlate hypoxia as measured by EF5 binding with tumor angiogenesis and apoptosis in these patients.
  • Correlate tumor perfusion with hypoxia in these patients.
  • Correlate tumor perfusion with microvessel density in tumor samples in these patients.
  • Determine the longevity of EF5 adducts in human lung tumors.

OUTLINE: Patients are stratified according to disease stage (stage I or II vs stage III vs no stage I-III determined after pathologic staging).

Within 24-48 hours prior to the planned surgical procedure, patients receive etanidazole derivative EF5 IV over 1-2.5 hours. Tumor hypoxia is then measured using an intraoperative Eppendorf needle electrode during surgical biopsy or resection. Tumor specimens are tested for EF5 binding using immunohistochemistry and flow cytometry.

Patients are followed at 4-6 weeks.

PROJECTED ACCRUAL: A total of 40-60 patients (20 with stage I/II disease, 20 with stage III disease, and 20 without stage I-III disease) will be accrued for this study.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Histologically or cytologically confirmed or suspected non-small cell lung cancer (NSCLC)

    • If there is no histological or cytological documentation of NSCLC, must have at least a 75% probability of having NSCLC
    • Clinical or pathological stage I-III

      • Patients in whom pre-surgical staging has not definitively established stage IV disease are allowed
  • Tumor mass of ≥ 1.5 cm in maximum diameter must be present on CT scan and must be included in the planned surgical biopsy or resection
  • Must be planning to undergo a surgical staging or treatment procedure (including mediastinoscopy, wedge resection, lobectomy, or pneumonectomy)



  • 18 and over

Performance status:

  • 0-2

Life expectancy:

  • Not specified


  • WBC > 2,000/mm^3
  • Platelet count > 100,000/mm^3


  • Bilirubin normal


  • Creatinine normal OR
  • Creatinine clearance ≥ 60 mL/min


  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception during and for 1 month after study participation
  • Able to hold breath for 27 seconds
  • No allergy to IV contrast dye
  • No history of grade III or IV peripheral neuropathy


Biologic therapy:

  • Not specified


  • Not specified

Endocrine therapy:

  • Not specified


  • Not specified


  • See Disease Characteristics
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00041028

United States, North Carolina
Duke Comprehensive Cancer Center
Durham, North Carolina, United States, 27705
Veterans Affairs Medical Center - Durham
Durham, North Carolina, United States, 27705
Sponsors and Collaborators
Duke University
National Cancer Institute (NCI)
Study Chair: Michael J. Kelley, MD Duke Cancer Institute
  More Information Identifier: NCT00041028     History of Changes
Other Study ID Numbers: Pro00011318
CDR0000069437 ( Other Identifier: NCI )
Study First Received: July 8, 2002
Last Updated: April 30, 2015

Keywords provided by National Cancer Institute (NCI):
stage I non-small cell lung cancer
stage II non-small cell lung cancer
stage IIIA non-small cell lung cancer
stage IIIB non-small cell lung cancer

Additional relevant MeSH terms:
Lung Neoplasms
Carcinoma, Non-Small-Cell Lung
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Lung Diseases
Respiratory Tract Diseases
Carcinoma, Bronchogenic
Bronchial Neoplasms processed this record on July 21, 2017